Individual
JEROME M. SHALF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6372 MECHANICSVILLE TPKE, SUITE 103, MECHANICSVILLE, VA 23111-4705
(804) 730-4690
(804) 559-0333
Mailing address
6372 MECHANICSVILLE TPKE, SUITE 103, MECHANICSVILLE, VA 23111-4705
(804) 730-4690
(804) 559-0333
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101026575
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006702252
—
VA
05
—
010167167
—
VA
01
—
1851619
CIGNA
VA
01
—
237591
ANTHEM BCBS OF VA
VA
01
—
254787
MAMSI
VA
01
—
4063759
AETNA HMO
VA
01
—
45902
SENTARA
VA
01
—
79148
SOUTHERN HEALTH SERVICES
VA
01
—
79177
SOUTHERN HEALTH SERVICES
VA
Enumeration date
07/01/2006
Last updated
11/24/2009
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